Loading...
HomeMy WebLinkAboutTHE TABLELANDS BLK 5 LT 9The Tablelands Block 5 Lot 9 #051-801-23 Municipality of Anchorage Page 1 or 3 Development Services Department Onsite Water and Wastewater Program 1700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ek.us (907) 3117904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO40357 PID Number. 051.801.23 "�"nell Homes S i Wastewater System: New Fes... 1900 W. Northern LI hts Ste. 200 Anch., AK 99517 ABSORPTION FIELD 344 5678 F ve 5 5' Wide Trench LEGAL DESCRIPTION so+a.rp Tar Pyre wan ag•W V••• ,45 GPD,Fe 7 Ft. Block Lot sutmmrm. D.M b Pip. cora, hon ayrW arp. Q. a.pn c.rrWr P" 5 9 Tablelands 3 Fr. 4 FL TOW W W n.Vk sad,at FA O*W.ow. arNrW yaq. G.vr L.rgik 0.2 Fr. 168 Ft Well: Awwu water System G..r..a,, 5 Nw o r.. 2 >10 Ft. Ft C1141,11N4aran (PMN-. A a, c). Tar DOWXCrra b ar.G.apm mm p. arW Fr. Ft 1,680 Fel ASTM 3034 PVC Pray Dr. on..0 sulk w.rr l.wt Ft Pisano's Didworks9117.21/2004 YWa. Pu srr. cl M GM"d TANK PM Ct. F Ft SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To From Septic Tank Absorption Field Litt Station Holding Tank ohrmnva(e sawaru a Anchorage Tank 1,500 WON >200' >200' WA WA >25 Steel Two (2) aN+.o.w.br >100' >100' WA WA LIFT STATION — NONE ON LOT to L" >5' >10, WA WA Fourdom >5' >10, WA WA m at In. b in c... None Noted PMW M" a Moir rano hepryprn p.rka q R� BENCH MARK an as Finished Floor. 100.0 Ft Engineer's Stamp P Inspections performed by: T. Kimbrouah Dates: 1" 9/17/04 ; 49th • 2 9121/04`h Department and Human Services approval MICHAEL E •NDCR50N W � . o �W" if 4oHealth Reviewed and approved by Date:. ♦ No EE -4381 •�r4e�o P`�• • �. X� LO rn m a V U O Np m ,N, Z 8 � o w� J o M J H w j \ \ \ OF 0 Ze w F � C rnacc" 3 F c Q O QU rnm O L N wU)<h .Fzwe �aNm Lu � m p C1 m O m U) U) o AO v *r -o \ /11ti � N 10 Z d Z m � as Z£L.\ 00 -OZ -'a Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SW040357 TBM Page 3 of 3 PID No. 051-801-23 d XS U in U S 4 PROFILE AS -BUILT Scale: 1' - 20• .MICHAEL E. ANDERSON �A. No. CE -UNI •.•_ unvo4 _..'c MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 9, BLOCK 5, TABLELANDS S/D 0j./'••. No. C[r7 PERFORMED FOR: SPINFI_I HOMFS DATE:9/21/2004 PROJECT No -M0442 ��:: PARCEL ID,.- TECHNICIAN: T.L. KIMBROUGH Professional En DEPTH TEST HOLE #3 Type of Test: ❑ Percolation ❑ Visual (fw) 1 2 3 4 5 6 7 8 9 I 1 1 1 1 1 1 OB/OG SILTY SANDY GRAVEL MEDIUM COMPACTION GM SLOPE 0% SITE PLAN SEE SITE PLAN Y C Y WAS GROUND WATER ENCOUNTERED? No IF YES @ WHAT DEPTI1? 0% DEPTH OF WATER AFTER MONITORING: DATE OF MONITORING: DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH OF WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 6/23 1 10:05 9.38" 2 10:35 30 8.511 .881, 3 11:05 30 7.7511 .75" 4 11:35 30 711 .75" 5 12:05 30 6.2511 .75" PERCOLATION RATEL�O (MINANCFI) FERC. HOLE DIA, INCHES) TEST RUN BETWEEN: 4 Fr, and -5 FT. COMMENTS: SAME SOIL MATERIALS AS FOUND IN TEST HOLES I AND 2. NO IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRESOAKED PRIOR TO TESTING. TEST PERFORMED BY VETECII ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 2/23/2005 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX MEMORANDUM DATE: March 7, 2005 TO: Julie Makela, P.E. FROM: Mike Anderson, P.E. SUBJECT: Lot 9, Block 5, Tablelands Subdivision Septic System Inspection Report As -Built Survey The profile view of the Septic System Inspection Report has been amended to indicate the correct elevations for the trench bottom of the absorption trench. A minimum of 4' of drainfield rock was placed under the distribution line. The crew working on the project were inexperienced and were not exact in the placement of the monitor tubes. The post tank cleanouts were moved to within 10' of the septic tank after the surveyor's as -built was completed. We have modified the as -built to show the current placement of the post tank cleanouts. Municipality of Anchorage Development Services Department • +� Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Anderson Engineering Legal description: The Tablelands, Block 5. Lot 9 The attached paperwork has been reviewed and Is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. _ ❑ Incomplete; missing ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. _ ❑ Proposed system too deep for soils Information submitted. _ ❑ _ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. 1.) Please verify depth of sewer rock beneath absorption fiel< surveyors as -built and Inspection Report site plan). Name of reviewer. Julie Makela. P. E. Date: 3/4/2005 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial yt7:00 '7I9,i 170 Date Issued: Aug 24, 2004 Expiration Date: Aug 24, 2005 Permit Number: SW040357 Parcel ID: 051-801-23 Legal Description: THE TABLELANDS SUBDIVISION BLOCK 5 LOT 9 Design Engineer: 0014 Anderson Engineering Site Address: NHN WHISPERING BIRCH DRIVE Owner Name: SPINELL HOMES, INC. Lot Size: 40003 SQ. FT. Owner Address: NHN WHISPERING BIRCH DRIVE Total Bedrooms: 5 Permit Bedrooms: 5 EAGLE RIVER. AK 99577 - This permit Is for the construction of. Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Maximum depth of aborption trenches shall not exceed 7 feet below original grade. Received Date: Municipality of Anchorage • Development Services Department Building Safety Division i On -Site Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OSI - 801-a3 Permit Number SW Property owner(s) Sgineit Homes, Inc. Day phone 3445678 �M,aaiiling address (1)1900 W. Northern Lights Boulevard, Suite 200 Anchorage, AK 99517 IA 4mg address (2) NM \kPl3PF.RINI '?ArLb Dr. M Zip Code _ Qi5-4-4- Legal description (Lot, Block & Sub'd.) lot 9. Block 5. Tablelands Subdivision Legal description (Section, Township & Range) Lot Size 40.003 SF Acre THIS APPLICATION IS FOR: Number of Bedrooms Five (5) Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: ` '100 - Date l00Date of Payment 131 1 q W Waiver Fees: Date of Payment Receipt Number. Receipt Number. (Rev, 12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX August 18, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 9, Block 5, Tablelands Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 9, Block 5, Tablelands Subdivision intends to construct a new five - bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. The subdivision is served by a community water system and no conflicts exist with adjacent septic systems or wells. The attached Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site. The water service line is also shown. The current drainage pattern along with spot elevations is identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. A test hole recently placed on the lot indicated silty sand and gravel in the area of the absorption trench. The accepting soils were tested and found to have a percolation rate of 40 minutes per inch. No groundwater was found in the test holes during placement and none was noted during the monitoring period. Our design includes the placement of a new 1,500 -gallon septic tank along with 2 - 84' long by 5' wide by 4' effective depth absorption trenches to collect and treat the sewage generated in the house. The bottom of the trenches will be 7' below the surface. The distribution pipe will be 3' below the surface. A minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank. The ground surface on the lot slopes at shallow grades from south to north as shown on the Site Plan. The absorption trenches will be constructed parallel with the slope of the ground surface as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 10' from the water service Lot 9, Block 5, Tablelands August 18, 2004 Page Two proposed for the lot and on adjacent lots. It will also be constructed a minimum of 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. .S�,i�n�ce�r�/e�ly,� F Michael E. Anderson, P.E. Attachments _O V) mY U 0. U) a o m n 0 N cy� O W J o mQ J F- W H LOT 9, BLOCK 5, TABLELANDS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom House 5' Wide Trench System Pero Rate: 30-60 Min./inch 1,500 Gallon Septic Tank Application Rate: A5 GPD/SF 4' Drainfield Rock 5 Bedrooms X 150 GPD/.45 GPD/SF (Application Rate) = 1,666.7 SF Absorption Area 1,666.7 SF/5 SF • .5 (Red. Factor) = 166.7 LF Trench Length THEREFORE: Construct 2 - 84' Long x 5' Wide x 4' Effective Depth Absorption Trenches. Flow Line Elevation in Trenches to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Provide 2" of Insulation and 2' of Cover if Necessary. Placea Flow Splitter Valve to Insure Even Flow to Each Trench. 2'6" 6" 4'0" TYPICAL 5' WIDE 7 NOTE: Natural Backfill 5' SCALE) Geotextile Fabric Perforated rC (Holes Down) Drainfield Rock Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 10' Separation From Water Services in the Area. Minimum 100' Separation From Surface Water or Streams. DEPTT Ir,�n MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 9. BLOCK 5. TABLELANDS S/D PERFORMED FOR: SPINFI I DATE: 8/3/2004 PROJECT No•M0464 PARCEL IDN- TECHNICIAN: T. L. KIMBROUGH 1 TEST HOLE # 1 SILTY ORGANICS/OB SLOPE SILTY—SANDY—GRAVELS GM m IT PAN TH2 0 '!H1 0 CURE KEY SFF FUTURF ASRUII T WAS GROUND WATER ENCOUNTERED? NO IF YES 0 RTIAT DEFTIV 0% DEPIN OF WATER AFTER MONITORING: NONE DATE OF MONITORING: R�ISro(. DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH R F (INCHES) INET DROP (INCHES) 8/3/04 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 11:00 11.5" CHARGE 2 11:30 30 10.75' 0.75" 3 11:30 12.0" RECHARGE 4 12:00 30 11.25" 0.75" 5 12:00 12.0" RECHARGE 6 12:30 30 11.25" 0.75" PERCOLATION RATE`(MIN/INCII) PERC. HOLE DIA,�INCIIES) .5 TEST RUN BETWEEN 4FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECH ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE- MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: LOT 9. BLOCK 5. TABLELANDS SID PERFORMED FOR: SPINFI I DATE: 8/3/2004 PROJECT No -M0464 PARCEL ID,#- TECHNICIAN: T. L. KIMBROUGH DEPTII TEST HOLE # 2 Ox1) 1 SILTY ORGANICS/08 SLOPE 0% O:lIQ VWAS l GROUND WATER ENoouNTrRmr n rDEPTH OF TERR AFTER MONITORING: le 14 15 16 17 18 19 0 NEL L ANDERSQI No. CE -4381 i SITE PAN TH2 0 THA 0 CURB KEY 1 a' SFF FUTURE ASRUILT �0 DATE READING G OSS TIME MINUTES) NET TIME (MINUTES) DEPTH OF WATER (INCHES) NET DROP (INCHES) 8/3/04 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 11:05 12.0" CHARGE 2 11:35 30 10.875" 1.125" 3 11:35 12.0" RECHARGE 4 12:05 30 11.25" 0.75" 5 12:05 12.0" RECHARGE 6 1 12:35 30 1 11.251@10.75" PERCOLATION RATE;-4-0(MW/INCFq PERC. IIOLE DIA, � (INCIIES) TEST RUN BETWEEN 4.5 FT. and 5.5 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECII ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 9, BLOCK 5, TABLELANDS SUBDIVISION GENERAL: 1. The scope of this project includes the procurement and placement of a new 1,500 -gallon septic tank at the location shown on the Site Plan. Work also includes the construction of 2 new 84' long X 5' wide X 4' effective depth absorption trenches at the location also shown on the Site Plan. The distribution line in the trench will be placed at 3' below the existing ground surface. Total depth of the trenches will be 7' below the existing ground surface. A flow splitter valve must be placed to insure even flow to each trench. A separation distance of 10' from any water service and 100' between the septic tank and absorption trenches and any surface water must also be maintained. A minimum of 3' of fill is required over the absorption trenches and 4' over the septic tank. In lieu of the required fill 2" of insulation and 2' of fill may be placed. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,500 -gallon septic tank must be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. Lot 9, Block 5, Tablelands August18,2004 Page 2 of 3 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 9, Block 5, Tablelands August 18, 2004 Page 3 of 3 MATERIAL SPECIFICATIONS: Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. Parcel I.D. 0 Municipality of Anchorage On -Site Water and Wastewater Program _ _7y 343-79044 `� tJ CERTIFICATE OF ON-SITE SYSTEMS APPROVAL X51 -93 1. GENERAL INFORMATION Complete legal description expiration nate: _ �0 -/ O - 1 The Tablelands S/D, Block 5, Lot 9 Location (site address) 22855 Whispering Birch Drive, Chugiak, Alaska Current Property owner(s) HOavard Hunt Day phone 632-80921r, 6692_3KfaMV Mailing address Real Estate Agent Audrey Mason, ReMax of Eagle River 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 622-3344 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual n Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System Ej Public Sewer ❑ Received by: Date: �Z COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $. I40l0 Waiver Fee $ Date of Payment 1 C3� z CJI \A r, Date of Payment Receipt Number O ��j ��j� Receipt Number COSA # 0bC i a t A�(.c Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, Shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Douglas T. Kenley, P.E. Phone (907) 74&-1073 Address 9806 E. Northstar Circle, Palmer, AK 99645 Engineer s Prilrted Name Douglas T. Kenley C --- S. ©SD SIGNATURE System #1 Approved for, bedrooms. System #2 Approved for. bedrooms. Disapproved. Conditional approval for bedrooms, with the following By: Zt/, Original Certificate Date: /V - 25- '/Z Theunicip ity age Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 6 by an independent professional cW engineer registered in the. State of Alaska.. Tisa Municipatrty of Anchorage is not responsible for errors or omissions In the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory_ Arsenic Advisory Well Flow Advisory Other COSA btue sheet A1-12.tl c If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: The Tablelands S/D, Block 5, tot 9 Parcel ID: 051-801-23 A. WELL DATA WellPublic type _ If A, B, or C provide PWSID # _ Well Log (Y/N) Date completed T Sanitary seal (YIN) Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level hJ Well production g,p,m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: _ ug/L date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1500 gal. Number of Compartments 2 Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. 9 - P.m - Other bacteria colonies/100 mL Collected by: Date installed 9/17-21/04 Clesnouts (Y/N) Y Foundation cfeanout (Y/N) Y Depression over tank (YIN) N High water alarm (YIN) N/A Date of pumping 9/27/12 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA Date installed 9/21/04 Soil rating (g.p.d./ftz orftZlbdrm) 0.45 System type 5' Wide Length 168 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth7=9 ft. Eff, absorption area 1680 ftz Monitoring tube Y Depression over field N Date of adequacy test 10/10/12 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 36 in. Water added 935 gal New depth�'s in. Elapsed Time: 1243 min. Final fluid depth 36 in. Absorption rate >= 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date -- D. uFTSTATM 0 -ate installed "Pump Datum Size in gallons in. "Pump off" level at _ in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/liftstabi on lot Manhole/Access (Y/N) High water alarm level at Meats alerrwit requirements? equirements? On adjacent lots A tion field on lot On adjacent lots _ - ' Public sewer main Public sewer manhole/cleanout Sewer ]septic service line Holding tank Animal containment areas Manurefanimail e=ete storage SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ ft. Property line 10+ IL Water main 10+ ft. Water service line 10+ ft. Wells on adjacent lots 100+ ft. ABSORPTION FIELD ON LOT TO: Property line 10+ ft. Building foundation 10+ ft. Water Service line 10+ ft. Surface water 100+ ft. Curtain drain None Known Welts on adjacent lots 200+ ft, Absorption flet Surface water in. d 5+ ft. 100+ ft. Water main 10+ ft. Driveway, parking/vehicle storage 5+ ft. F. COMMENTS There are two trenches. The bottom trench had 48" at the beginning of the test. Water was introduced into the top trench which had two monitoring tubes, but only one is shown. Its readings were 31", 34-5/8", and the final reading was 32-3/4". G. ENGINEER'S CERTIFICATION 1 certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA gufdeif res in effect on Um date. Engineer's Printed Name Douglas T. Kenley Date I fl�LZ�f v CDSAbrnvm s1ems 9-1-1244 eeanso� TIDO �+eoEwn euWrc mam S I Irr f / �1341 / CGsx2� / O ' E%i5TING HOUSE 19" \\Is Al \ G/ / UNDER NO CIRCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUS14WO BOUNDARY OR FENCE IDES THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY, LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. WT AIRt£[ SURVEY TYPE SYMBOLS FaLYgATwN AS-ears El FINN. SmemE A4-BllrT T REBAR 7 W DRAINAGE 0 ASPHALT ❑ PIDT PINI ... Ae-&ULT ... LM sMLEY _ .. RPOQIAPHY -FENCE..® CONCRETE ET A9-&Ri ... W Mftn SET Rf TIRi AS-BULT ... WNt{R9 gT ® ASSUMED ELEV. -1( It 11- MM,LL FENCE WOW DECK PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE SHOWN. FENCES, YELLS, SEPTIC CLEANOUTS. SIDEWALKS ORIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIFICATION'.�tt��r ' Prepared by PLOT PLAN Robert E. Johns, Jr. & Assoc. raw waw s rlsYw ar k M ..•'�� •, •!♦♦ • ♦♦ Gj Professional Land Surveyors Brews +w..a.. pw as w ar ew, a r•r wMi o�exra r sm+w nwe t� i j 1 �. II 1700 Brink Orkm ANCHORAGE, ALASKA 99504 III Scale: 1„ _ 56, J Rec Lot S.F. Rec. Plot File No. FOUNDATION AS-BUILT • l AmfR C .IAIw r_ Md] verj Ib! I ww Mvww a 4-aat wr+w R Ts _ ....... ....... .. ..,...ONS. Date SU Yom= 1 p Drawn by RE r� C G,eekee by Ja, M K :.. t Date Dram: DriO: W.O. ♦�♦a A �2t 16/24/12 1559 12-466 ANAL 9 LURE AS-alrT t R~ c rrs r. irwy uab aa, I ,..',a�� '•.. .: o� �� Legal Description: � '" ♦♦ eoP a...............ara :• Lot 9 BLOCK 5 eas THE TABLELANDS Municipality of Anchorage +` Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Septic System Advisory Certificate of On -Site Systems Approval # 121486 During a recent adequacy test on the septic system for Block 5, Lot 9 of The Tablelands subdivision, 36 inches of standing water was observed in the absorption field. This indicates that approximately 88% of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval Municipality of Anchorage • --' Development Services �Department , Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. D51-wi-93 COSA#_ MY14 Expiration Date: / O -- � S? — O 1. GENERAL INFORMATION Complete legal description The Tablelands SID, Block 5, Lot 9 Location (site address) 22855 Whispering Ruch Drive, Chugiak, Alaska Current Property owner(s) FHLMC Mailing address SCCA (�LANi) PR' 1111 Lending agency Countrywide Home Loans Day phone Day phone (907) 357-5990 Mailing address 1981 East Palmer-Wasilla Highway, Suite 200, Wasilla, Alaska 9%54 Real Estate Agent Cad Brent, Century 21 Day phone (907) 352.5100 Mailing Address 991 North Herman Road, Suite 100, Wasilla, Alaska Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site❑ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑� Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address Douglas T. Kenley, P.E. Phone (907) 746.1073 9606 E. Northstar Grde, Palmer, Alaska 99645 Engineer's Printed Name Douglas T. Kenley 5. DSD SIGNATURE t,"" Approved for bedrooms. Date 0� OF A 4s� µ Disapproved. :f_r Conditional approval for bedrooms, with the following stipulations: .r• .,) T KDW Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Well Flow Advisory Nitrate Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Dater (Rav /veal r.. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: The Tablelands SID, Block 5. Lot a Parcel ID: 051.601-23 A. WELL DATA Well type 22bN If A. B, or C provide PWSID # — Well Log (YIN) Date completed — Sanitary seal (YIN) _ Wires properly protected (YIN Total depth ft. Cased to ft. Casing height (a ground) in. FROM WELL LOG ATI CTION Date of test Static water level Well production WATER SAMPLE Coliform 9 P.M. mL Nitrate mg/L 9.p -m. Other bacteria colonies/100 mL Arsenic: mgA Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/17-21/2004 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) NIA Date of pumping 10222006 Pumper Sanitary Pumpom C: ABSORPTION FIELD DATA Date installed 0212004 Soil rating (g.p.d.Rt2 or ft2lbdrm)±5 GPD/SF System type T wide shallow trench Length ' 64+64=166 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 6 ft. Eff. absorption area 1660 fe Monitoring tube Y Depression over field N Date of adequacy test 1O21 8 t0r3M Results (Pass/Fail) Pass For 5 bedrooms Fluid depth In absorption field before test Din. Water added "m° gal. New depth 14.37 &*" in. Elapsed Time: 1447 min. Final fluid depth 10.5 in. Absorption rate >= 750 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 8 type) N If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on' level at_ in. 'Pump off" level at w:15,0 alarm level at in. Da Cycles tested Meets alarm & circuit requirements] E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent I Pubtic sewer main Public sewer manhotelcleanout p Ic service line Holding tank Animal containment areas 50+ft. Manure/animal excrete storage areas loo+ft. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ ft. Property line5+ ft. Absorption field 5+ ft. Water main 25+ ft. Water service line 10+ ft. Surface water 100+ ft. Wells on adjacent lots 200+ ft. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ ft. Building foundation 10+ ft. Water main 25+ ft. Water Service line 10+ft. Surface water 100+ ft. Driveway, parking/vehicle storage 20 ft. Curtain drain "onsh pxn10°•"' Wells on adjacent lots 200+ ft. F. COMMENTS: On test dated 10/23108. the beginning water level was at 9•. After 917 gallons was introduced, the level was 11-1/4•. Jeff Poet at the MOA office was consulted during these tests. G. ENGINEER'S CERTIFICATION �'� TM�.A� •�e'i I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. s� ' c9y S T )�lM Engineer's Printed Name Douglas T. Kenley ��� •' CE 9174 ' Date 162c zo!b COSA Fee $ 4.30 Date of Payment to n�� ��g Receipt Number 15 (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number �Uc�ur -doc.. Municipality of Anchorage Development Services Department < Building Safety Division Onsite Water and Wastewater Program SA ITT 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051801.23 HAA# 1SObi7 Expiration Date: � 12h= p 1. GENERAL INFORMATION Complete legal description Lot 9 Block 5 Tablelands Subdivision Location (site address or directions) 9.2$55 Whispering Birch Drive t Current Property owner(s) Soinell Homes, Inc. Day phone 3445678 Mailing address 1900 Northern Uahts Blvd. Anchorage AK 99517 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Five 5 TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site ❑ Individual Holding tank ❑ ❑ Community On-sfte ❑ ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my Investigation, based on procedures outlined in the Healty authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn _Anderson Engineering Phone 522.7773 Address P.O. Box 240773 Anchorage. AK 99524 Engineer's Printed Name Michael E Anderson, RE Date 2123/2005 '.LY V 49th 5. DSD SIGNATURE Na co-r3ffi _Ie�— Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report . Other By: At. . . 0.0 � � Q Original Certificate Date: (Rr. tm) Municipality of Anchorage • Development Services Department Building Safety Division On-site Water b Wastewater Program 4700 South Brag8W SL P.O. Box 196850 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 A. WELL DATA Well hype _ Date completed Total depth ft Date of test Static water level Well production HEALTH AUTHORITY APPROVAL CHECKLIST If A, B, or C provide PWSID # Sanitary seal (Y/N)— Cased to ft FROM WELL LOG WATER SAMPLE RESULTS: Coliform colonies/100 ml. Date of sample., B. SEPTICIHOLDING TANK DATA ft 9 -p.m - Nitrate mg.A. Collected by. Tank Type/Materlal 60011COW Tank size'1 MO gal• Number of Compartments I Foundation deanout (Y/N) Y Date of pumping C. ABSORPTION FIELD DATA Well Log (YIN) Wires party p (YIN) Casing height (above ground) in. AT INSPECTION ft g.p.m. Other bacteria Date installed 9HTrM Cleanouts (YM) Y colonies/100 ml. Depression over tank (YIN) )y High water alarm (YIN) N Pumper Now Construction Date installed 921rM Soil rating (g.p.d.M or felbdrm) A GPQW System type S Wide Shallow Trench Length 199 ft. Width 3 ft Gravel below pipe 4 __ ft Total depth 0 ft Eff. absorption area 1.680 ft? Monitoring tube y Depression over field N Date of adequacy test Results (Pass/Fall) For — bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth.— in. Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >- g.p.d. b type) N If yes, give date Any rejuvenation treatment (past 12 mo.) (YIN i II D. LIFT STATION Date installed Size in gallons 'Pump on' level at _ in. 'Pump off level at_ in. It -Z I Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankf ft station on lot WA Absorption field on lot WA Public sewer main WA Manhole/Ao ess (Y/N) High water alarm level at in. Meets alarm 6 circuit requirements? On adjacent lots WA On adjacent lots WA Public sewer manhoie/deanout WA Sewer /septic service line WA Nodding tank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >S Property line ? Water main >1o' Water service line >10, Surface water MW Wells on adjacent bis >2W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >1W Building foundation >10' Water main MW Water Service line >10' Surface water >IW Driveway, parlangNehida storage >S Curtain drain None Noted Wells on adjacent lots >21V_ F. COMMENTS G. ENGINEER'S CERTIFICATION .T 1J::: I certify that I have determined through field inspections and 49th review of Municipal records that the above systems are in i cwkwmance with MOA HAA guidelines in effect on this date. ;rmdaEL E. ANOM Engineers Printed Name Michael E Anderson, PE, Bei„.. No. CE -an Data 2M 05 HAA Fee $ 57 Waterer Fee $ Date of Payment f- ZJ - o S Receipt Number `!g VS (Rev. 12!00) FVI Date of Payment Receipt Number Air a i 0 Z D m z o t� m O �_ Toorn�r Cn N Z�*•Do I u m m U) D w N m A m 0 co r O o N v,�'xv_c —I O i ��„ u Ln m �< z r . mxcDte)m=1mm- N m ' z -0 Z D I;Do-O<mNn0n rn O Sw 0 Z K x p� ai O = z Z rr, n - � ZO �' zmzW ;n K: C) -ix C, 70 Om.,m�mo�n1 mo z -n :ncnNNxo U) ;uoo ,��-'�mm x N o xO-:2rnF-iDD Molz- m� cn z -cam o_+c):�mo- '�' o OO'�rri6m x< :o nm N 0, Z C r j 10= Z m y p N Di _{ mC h<_ ON=m m ZZZQ oo(nZo-' N mo-<zOrnm0 rn ov,>'o�oo = .x D En m c m D O r- m z O ,CD0� n n N V' N O CCCf)r C CP �_ Cf) O z